AED - Anti-bacterial Agents I - Week 5

Question 1

List the six considerations in therapeutic management and list components for each if applicable.

Answer 1

Diagnosis
-exclusion
-provisional
-reconsideration
Drug, dose, frequency
-contraindications
-interactions
-modifying factors
Patient instructions
Review schedule
Treatment success
-side effects
Sustain or alter approach

Question 2

List the 11 classes of anti-bacterial agents used in ocular disease management.

Answer 2

Fluoroquinolones
Aminoglycosides
Tetracyclines
Macrolides
Penicillins
Cephalosporins
Glycopeptides
Chloramphenicol
Gramicidin
Bacitracin
Polymixin

Question 3

What is propamidine used for? List another agent used for this purpose.

Answer 3

A general ocular disinfectant
Povidone-iodine is another example

Question 4

What eye conditions are fluoroquinolones generally used for (1)?

Answer 4

Bacterial keratitis

Question 5

What eye conditions are aminoglycosides generally used for (6)?

Answer 5

Prophylaxis following surgery/trauma
Bacterial conjunctivitis
Blepharitis
External hordeola
Canaliculitis
Dacryoadenitis

Question 6

What eye conditions are tetracyclines generally used for (4)?

Answer 6

Blepharitis
Meibomianitis
Acne rosacea
Chlamydia (always oral)

Question 7

What eye conditions is chloramphenicol generally used for? What is different with this agent?

Answer 7

The same as in aminoglycosides, but is bacteriostatic rather than bactericidal

Question 8

What eye conditions is neosporin generally used for?

Answer 8

As for aminoglycosides

Question 9

What is a downside to the use of neosporin?

Answer 9

Possible hypersensitivity response

Question 10

Is neosporin available in Australia?

Answer 10

No

Question 11

What eye conditions are macrolides generally used for (3)?

Answer 11

Chlamydia
Blepharitis
Childhood bacterial conjunctivitis

Question 12

What eye conditions are penicillins generally used for (2)?

Answer 12

Canaliculitis
Chronic conjunctivitis (oral)

Question 13

What eye condition are cephalosporins generally used for (2)?

Answer 13

Bacterial keratitis (oral)

Question 14

What eye conditions are glycopeptides generally used for (1)?

Answer 14

Endophthalmitis

Question 15

Are fluoroquinolones safe for use in pregnancy, lactation, and children?

Answer 15

Avoid use in pregnancy and lactation
Generally thought to be safe in children

Question 16

Are aminoglycosides safe for use in pregnancy, lactation, and children?

Answer 16

Caution in pregnancy
Generally thought to be safe for lactation and children

Question 17

Is chloramphenicol safe for use in pregnancy, lactation, and children (2)?

Answer 17

Safe
Caution if there is a family history of blood dyscrasia

Question 18

Are tetracyclines safe for use in pregnancy, lactation, and children (5)?

Answer 18

Contraindicated in pregnancy and lactation
Causes tooth discolouration in children (unlikely in topical doses)
Best to avoid use in all three

Question 19

Is neosporin safe for use in pregnancy, lactation, and children?

Answer 19

Caution in all three

Question 20

Are macrolides safe for use in pregnancy, lactation, and children?

Answer 20

Azithromycin - caution in 2/3 trimester and lactation

Question 21

Are penicillins safe for use in pregnancy, lactation, and children?

Answer 21

All three safe

Question 22

Are cephalosporins safe for use in pregnancy, lactation, and children?

Answer 22

All three safe

Question 23

Are glycopeptides safe for use in pregnancy, lactation, and children?

Answer 23

Unsafe in pregnancy
Safe for lactation and children

Question 24

What is a good antibiotic for gram positive bacteria?

Answer 24

Chloramphenicol

Question 25

What is a good antibiotic for gram negative bacteria (2)?

Answer 25

Aminoglycosides
Fluoroquinolones

Question 26

What is the difference between prophylaxis (3) and therapy (3)?

Answer 26

Prophylaxis
-broad spectrum cover
-quick attainment of protective levels
-treat until risk of infection is over
Therapy
-should target a specific organism if known
-quick attainment of therapeutic levels
-therapy continues until organism is eliminated

Question 27

In what 7 cases is laboratory testing for bacterial conjunctivitis mandatory?

Answer 27

Severe chronic
Hyperacute
Ophthalmic neonatorum
Membraneous
Parimaud’s oculoglandular syndrome
Post-operative infection
Associated corneal ulcer

Question 28

What often causes hyperacute bacterial conjunctivitis?

Answer 28

Gonorrhoea